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Case Studies

The Impact on Quitlines When Graphic Warning Labels Include a Quitline Number: Australia and New Zealand Case Studies

As of August 2012, 56 countries in the Americas, Eastern
Mediterranean, Europe, South-East Asia and Western Pacific regions require
pictures or images on cigarette packs (some of these are still being
implemented).1 Graphic Warning Labels (GWLs) on tobacco packaging in
countries like Canada, Australia and New Zealand include concrete information
on ways to quit such as quitline numbers and website addresses and their
experiences to-date indicate that including cessation resources on the label
are an effective way to encourage tobacco users to quit. In fact, approximately
20 nations currently require a quitline number on their tobacco package
labeling, including Finland, the Netherlands, Denmark, Iceland, Malta, the
U.K., France, Sweden, Hungary, Poland, Germany, Belgium, South Africa, Brazil,
Singapore, Australia, Switzerland, New Zealand and Norway.2

While the evidence on the impact of GWLs is clear and the evidence for the
effectiveness of the inclusion of a quitline number on warning labels growing,
less is known about the impact of GWLs on quitline operations when labels first
begin to include a quitline number. What
is the immediate impact on call volume when these labels are first announced
and how are spikes in volume best addressed operationally? Does volume become
increasingly steady over time? Do the types of callers to the quitline change
as a result and hence, counseling protocols? In an attempt to
answer these and other questions related to implementation and impact of GWLs
that include a quitline number, the Global Quitline Network (GQN) has published two case
studies that focus on four areas:

Preparing for implementation

Promoting the new warning
labels

Impact on quitline service
delivery and utilization

Evaluation of outcomes

Highlighting Australia and New Zealand, the purpose of the case studies is to describe
implementation of warning labels that include a quitline number within a
real-world quitline setting, noting the programmatic and operational issues
that emerged and how they were addressed. GQN’s aim is to provide quitline
service providers and quitline funders with valuable information to support
successful preparation and implementation.

A Case Study to Support Gaining Federal Medicaid Match for State Tobacco Cessation Quitlines: Maryland

With the goal to inspire, support, encourage and direct states in their cost-sharing efforts, this resource offers quick-to-read yet detailed guidance from one successful state, with broader lessons learned through NAQC’s Medicaid Learning Community woven throughout. Important things to consider before moving forward in partnership with Medicaid are highlighted, as well as building blocks for success. The case study includes the following sections:

1. Background2. Building the Relationship3. Challenges to the Relationship4. Building the Agreements: Memorandum of Understanding and Cost Allocation Plan5. Building the Infrastructure6. Challenges to the Process7. Final Thoughts8. Resources

Innovative Approaches and Proven Strategies for Maximizing Reach

In an effort to improve the reach across all quitlines in North America, and as part of an overall focus on critical quality measures including quit rates and reach to specific populations, NAQC has developed a Web repository of case studies on states that have achieved a reach that is at least three times higher than the median reach of all state quitlines.1 The information shared in this resource will help other members identify mechanisms and approaches for increasing the reach of their quitlines and is intended to compliment NAQC’s 2009 publication, Increasing Reach of Tobacco Cessation Quitlines (2009).

While it is important to remember that reach is not the only or most important measure of quitline value, the following case studies focus on experiences with various strategies intended to increase the reach of a state quitline. Each case study highlights the methods employed to maximize reach, opportunities, challenges, and lessons learned by states and their partners. These case studies can assist other states and provinces working to increase the reach of their quitline services by providing information about key outreach and promotional strategies and approaches and the potential impact on reach.

Each case study includes:

An overview of the strategic objectives of the quitline and the services offered

Providing Cessation Services during the Implementation of Smoke-Free Policies

The following case studies focus on experiences of states providing cessation services during the implementation of new statewide smoke-free policies. Each case study highlights the main issues, opportunities, challenges, and lessons learned by quitlines and their partners. These case studies can assist other states with plans to promote their quitlines during policy implementation by providing information about implementation strategies and approaches and the potential impact on quitline services. Learn more about this group of case studies.

1 In these case studies reach refers to promotional reach, calculated using 2008 NAQC Annual Survey data, and based on the total number of unique tobacco users calling the quitline. Please note this is not NAQC’s standard calculation of treatment reach, counting only those who receive at least some evidence-based treatment, but rather is based on the number of unique smokers calling the quitline divided by the total number of smokers in each state.